JP2018524078A - Device and kit for open surgery support - Google Patents

Abstract

Various examples of devices and kits for assisting and illuminating medical procedures are disclosed. These devices can be attached to a handheld medical device. In addition, various examples of medical procedures that can be performed using the device or kit are also disclosed. In addition, various embodiments for attaching an auxiliary medical device to a device attached to a primary medical device are also disclosed. [Selection] Figure 1A

Description

  This application claims the benefit of European Patent Application No. 15382341.4 filed on June 29, 2015.

  The present disclosure relates to devices and kits for medical procedures, particularly open surgical assistance.

  Surgery can generally be classified into laparoscopic or minimally invasive surgery and open surgery. In this sense, open surgery is to be understood as a traditional surgery that requires a relatively long incision to allow the surgeon to insert the instrument and visualize the surgery through the incision, and minimally invasive surgery is much more It is less invasive and involves a much smaller incision. According to the open approach, for example, a typical appendectomy incision is approximately 10 cm (4 inches) long. On the other hand, using minimally invasive techniques, the incision can range from 0.5 cm to 1.5 cm (1/4 to 1/2 inch), or some surgical procedures may have no incision. possible.

  An important element in laparoscopic surgery is the use of a laparoscope, a long fiber optic cable system that allows observation of the affected area. Laparoscopic surgery belongs to the field of endoscopy, ie, examination using an endoscope, which is a device used to examine the interior of a hollow organ or body cavity of the body. In laparoscopic surgery, the surgeon is actually operating from outside the patient's body that is outside the actual intervention site. The surgical instrument is controlled from a distance and reaches the intervention site via a tubular body (eg, a catheter).

  Illumination devices for illuminating medical procedures are known. Since some specialized medical practitioners typically need to improve the visualization of living tissue and / or body cavities, various lighting systems have been designed to address this problem.

  Currently, there are several ways to illuminate medical procedures such as, for example, open surgery in the operating room. One option is ceiling lighting mounted on the ceiling. Surgical lighting may be fixed to the ceiling or suspended from the ceiling by an arm operable to change the position and orientation of the lighting. However, these types of illumination are typically general diffuse illumination, which may lack the accuracy required to properly illuminate, pointing to the desired target direction depending on the type of intervention. This illumination may face the problem of casting shadows on the target, especially in body cavity or opening interventions.

  Another option is the use of a lighting device held in a human hand. In such cases, a surgeon or other operating room personnel may use a handheld lighting device such as a surgical flashlight. However, while the surgeon is holding the illumination device, the hand holding the lamp cannot perform other actions. Instead, if such a device is held by other personnel, the accuracy of illuminating the target may not match the specific requirements of the surgeon. As a solution to overcome some of the above limitations, surgical headlights can be used. However, surgical headlights are generally heavy and can be uncomfortable. Surgical headlights also need to be positioned and possibly adjusted during the procedure, and for that purpose, a free hand must be used. In addition, since the headlights and all associated equipment are not sterile, precautions need to be taken to avoid contamination of the surgical field.

  Similarly, during open surgery, physicians typically require a way to point devices, living tissue and / or body cavities to other physicians or personnel involved. The identification of the exact point of intervention and the necessary movement (eg, incision, needle advancement) can be crucial to complete these procedures. Verbal communication may not be properly directed. A laser pen may be used for such instructions.

  Many combinations of surgical instruments may be required during the course of open surgery. For example, it is very often necessary to cut one or more blood vessels during the course of open surgery. In such cases, usually after introducing a scalpel, the surgeon needs to provide a means to close and cauterize such blood vessels. Various surgical elements may be required to do this. Alternatively, it is known to use an electrosurgical knife or an electrosurgical pencil. In this way, the blood vessel can be cut and cauterized in one step. However, smoke can interfere with the surgeon's view during cautery. Thus, additional surgical instruments may be required, i.e., a surgical smoke aspirator, usually operated by a surgical assistant.

  Wireless guided surgery in which a patient is administered radioactive material is also known. The radioactive substance collects in cancer cells, for example. By using radioactive probes, tumors and affected tissues can be found and removed accurately. However, when the surgeon is holding the probe, the hand cannot perform other actions. Thus, typically the radioactive probe is held / operated by a surgical assistant. In most cases, both medical professionals cannot access the opening simultaneously for surgery. That is, one person uses a radioactive probe to find the affected tissue and inform the surgeon where to cut.

  Currently, many such combinations of surgical instruments are required simultaneously, including but not limited to cutting, suturing, aspiration, clamping, cauterization, cleaning, and various forms of tissue manipulation within the patient's body. Can be done. Visibility is very important in the above and other combinations of surgical instruments for open surgery, but is often not ideal because multiple people are needed to handle different instruments.

  The purpose of the embodiments of the present disclosure is to provide an alternative device and kit for assisting open surgery, in particular an alternative device for assisting or illuminating open surgery, which at least partially overcome some of the disadvantages described above. Is to provide a kit.

(None)

  According to the first aspect, an open surgery support device is provided. The device is attached to the base so that the base is configured to be attached to a portion of the handheld medical device and is directed to the distal end of the handheld medical device when the base is attached to the handheld medical device. And a lighting device. The device further comprises a base appendage having a receptacle configured to receive an auxiliary medical device.

  According to this aspect, an apparatus is provided that can be coupled to a handheld medical instrument (eg, an electric scalpel) to improve visualization during open surgery and that can couple an auxiliary device to the handheld medical instrument. Such auxiliary devices include, for example, surgical aspirators or smoke / liquid ejectors, laser pointers, handheld ultrasound systems, irrigators for electrocoagulation, separate lighting devices, radioactive probes, cameras, or sensors, etc. It can be.

  In general, these devices may be instruments that assist the surgeon, particularly while performing a surgery (eg, interaction with tissue) using a (primary) handheld medical instrument.

  No more medical personnel are needed to hold such an auxiliary device. Thus, the surgical procedure can be more effective, faster and safer.

  Attachment of the base and appendage locally increases the cross-sectional dimension of the medical device. However, in embodiments of the present disclosure, the appendaged base may remain outside the patient's body while the medical and assistive devices are fully within the body. In such a case, it is not necessary to make the surgical incision large.

  In some embodiments, the receptacle may be a through hole. Optionally, the appendage may comprise a tubular or annular portion that defines a through hole. Optionally, the tubular or annular portion can be made of an elastic material so that the auxiliary medical device can be received with a friction fit. In more alternatives, the receptacle can be, for example, an opening having a substantially C-shaped or U-shaped portion.

  In some embodiments, the appendage can be made from a rigid material. In other embodiments, the appendage can be made of an elastic material. The elastic material allows a secure friction fit. Due to the elasticity, auxiliary devices with slightly different dimensions can be fitted into the same through hole. Thus, a single appendage may be suitable for attaching a variety of different auxiliary medical devices, ie auxiliary medical devices having different diameters.

  In some embodiments, the device can include an appendage that can be integrally formed with the base. In other embodiments, the appendage can be removably secured to the base.

  In some embodiments, the single base is configured to receive a first appendage having a receptacle configured to receive a first auxiliary medical device and a second auxiliary medical device. And a second appendage having a receptacle. In some surgical methods, two auxiliary devices, such as a laser pointer and a surgical aspirator, may be required simultaneously.

  Depending on the situation, a device with a base and several appendages of different types (eg, appendages having different sizes and / or including rigid and / or elastic materials may be envisaged) may be used. .

  In more examples, the appendage can be an anti-slip strap attached to the base, or can comprise an anti-slip strap. The non-slip strap herein may be a strap, band, sling, or loop having a friction fit with an auxiliary medical container. In some of these cases, the strap may be attached with a Velcro® type hook-and-loop fastener. In some cases, an elastic band can be envisaged as a non-slip strap. The elastic band achieves a friction fit when stretched due to its tendency to return to its natural relaxed state. In yet another alternative, a combination of appendages such as appendages integrally formed with the base and / or removably secured to the base and / or a strap separated from the base may be envisaged.

  In another aspect, a kit for supporting open surgery, a base configured to be attached to a portion of a handheld medical instrument, and configured to be removably secured to the base, an auxiliary medical device And an appendage having a receptacle configured to receive the kit.

  In some examples according to any of these aspects, the lighting problem may be addressed by a device attached to a medical instrument or device, ie, a base with a lighting device. The medical instrument or device may be equipped with the lighting necessary to operate properly during medical intervention or surgery in a direct manner and in the vicinity of the medical procedure.

  The light source, for example, can improve the visualization of the surgical field, which is an important issue in surgery, while being lightweight and comfortable to use. The ability to attach the device or kit to a variety of medical devices makes it a versatile device that can be used at a convenient time in addition to the device or device. Furthermore, this makes it possible to replenish already discarded equipment, reducing costs and greatly improving equipment performance.

  The device (and / or accessory) is disposable and can be used only once. In other examples, the device or kit may be used multiple times and configured to be sterilized after each use. In either case, contamination of the surgical field can be effectively avoided.

  In some embodiments, the lighting device may be an LED. LEDs maintain a high level of lighting while providing a cost effective solution. The LEDs require little maintenance and are cold, thus avoiding overheating or undesirable temperature fluctuations (eg, when a thermometer is needed near the light source). The LED can be provided with a variable intensity controller so that it can adapt to changing demands. Alternatively, the lighting device can be a fiber optic light source. In another example, the base may comprise more than one lighting device.

  In another example, one or more incandescent bulbs may be used.

  In yet another example, the base may comprise a central opening configured to be attached around a portion of the handheld medical device. Optionally, the base may comprise an O-ring or diaphragm made of a relatively flexible material that surrounds at least a portion of the central opening. This feature allows the device or kit to be adapted to a number of handheld medical instruments, particularly instruments used in open surgery, and particularly adapted to be attached to instruments such as a scalpel.

  In an alternative, the base may comprise a hinge between the first half and the second half of the base, in which case the biasing element connects the first half and the second half to each other. Make contact. This feature allows the outer portion of the base to be moved in the desired direction.

  In yet other embodiments, the base may comprise an attachment ring disposed at or near the edge of the base for attachment to a medical device.

  During open surgery, the surgeon may decide whether to attach a base around the medical device, depending on the particular situation. If the situation changes as the surgery progresses, the surgeon may decide whether to attach the base (and / or appendage) or remove the base (and / or appendage) from the instrument currently in use. It may be judged again.

  The same base can be attached to different instruments due to the flexibility or elasticity in the attachment method.

  In some embodiments, the device or kit may further comprise an electrical cable for connecting to a power source. Multiple controllers and / or switches may be provided in the power source. It may be advantageous if the lamps can be turned on separately or collectively with regard to switching on or off individual lamps or operating them. This controls on the one hand the light intensity and on the other hand the emitted wavelength, while at the same time another element that may or may not be further provided in the base independently of the light source (e.g. A special option is obtained to control the use of the laser pointer. Thus, the device / kit can be optimally adapted to individual applications.

  In some embodiments, the electrical cable comprises a plurality of fasteners for attachment to a handheld medical device. The fasteners (which can be several types of fasteners) allow a compact and convenient attachment of the base to the medical device so that the cable does not interfere with the medical professional. In the alternative, multiple fasteners may be attached to a medical device (eg, a handle portion of a medical device). For example, eyelets can be used to guide electrical cables.

  Some feasible configurations can be adapted to the requirements of multiple procedures and / or applications with the most useful and frequent use. Thus, in some embodiments, another auxiliary device can be a sensor, smoke and / or liquid aspirator, an ultrasonic sensor, or another imaging device (eg, a video or photographic camera).

  In some embodiments, the kit is configured to be removably secured to the base and includes a first appendage having a first receptacle configured to receive a first auxiliary medical device; A second appendage having a second receptacle configured to be removably secured to the base and configured to receive a second auxiliary medical device, wherein the first accessory The receptacle has a different size or shape than the second receptacle.

  The surgical kit comprises different accessories for attaching different auxiliary devices or different types of auxiliary devices. The base includes a first fastening element, and the appendage includes a second fastening element and is configured to engage the first fastening element and the second fastening element. In some cases, a single fastening element is provided for coupling with either the first appendage or the second appendage. In some other cases, the base comprises first and third fastening elements for simultaneous coupling with the first appendage and the second appendage.

  In some examples, the laser pointer can be attached to the base such that when the base is attached to the handheld medical device, the laser pointer is substantially directed to the distal end of the handheld medical device. The apparatus or kit may further comprise a power source for supplying power to the laser pointer.

  According to this aspect, the instrument for accurately indicating the biological tissue of the target body part is disposed in the vicinity of the body cavity. Further, the laser pointer can be easily controlled without disturbing the medical professional.

  According to another aspect, an apparatus for illuminating a medical procedure is provided. The device includes a base attachable to the handheld medical device, a lighting device mounted on the base, and a base so that the base is substantially directed to the distal end of the handheld medical device when attached to the handheld medical device. And may further include a connection for connecting to a power source to power the illumination device and the laser pointer.

  In yet another aspect, a method is provided for replacing a first auxiliary medical device attached to a receptacle of an appendage of an open surgery support device when the base of the open surgery support device is attached to a portion of a handheld medical device. Is done. The method includes providing the handheld medical device to the surgical position with an appendage supporting the first auxiliary medical device; pulling the handheld medical device back from the surgical position; removing the first auxiliary medical device; Attaching a second auxiliary medical instrument to the open surgical support device and positioning the handheld medical instrument in a surgical position. According to this aspect, the method is performed during open surgery.

  As used herein, a surgical position is to be understood as a position that projects beyond an incision in the patient's skin so that the handheld medical device can perform a surgical operation.

  According to this aspect, in an embodiment, as the situation progresses as the surgery progresses, the surgeon can decide to attach or remove a different auxiliary medical device to or from the appendage, and thus open. Different combinations of instruments can be used fairly quickly during surgery. In laparoscopic surgery, such procedures are much more complicated because the surgical instrument is located further away from the surgeon.

  In some examples, removing the first auxiliary medical device may include removing an appendage from the open surgical assist device. In some of these embodiments, attaching the second auxiliary medical device to the open surgery support device includes attaching a second accessory to the open surgery support device. Thus, replacing one auxiliary medical device with another auxiliary medical device can include quickly removing the auxiliary medical device and changing the appendage to attach. In other embodiments, the first auxiliary medical device can be removed from the appendage and the second auxiliary medical device can be fixedly attached to the same appendage.

  In yet another aspect, a method is provided for altering an auxiliary medical device attached to a receptacle of an appendage of an open surgery support device when the base of the open surgery support device is attached to a portion of a first handheld medical device. Is done. The method includes providing a first handheld medical instrument with an appendage supporting a first auxiliary medical device to a surgical position, retracting the first handheld medical instrument from the surgical position, and first handheld medical Removing the open surgical support device from the instrument; providing a second handheld medical instrument; attaching the open surgical support apparatus to the second handheld medical instrument; and positioning the second handheld medical instrument in the surgical position. Including the step of. According to this aspect, the method is performed during open surgery.

  According to this aspect, during open surgery, the open surgery support device can be removed from the main handheld medical instrument and then attached to another handheld medical instrument while supporting the same auxiliary medical instrument. In particular, if the device comprises a base having a central opening for mounting around a portion of a handheld medical device (eg, comprising a ring or diaphragm of flexible material), the device is slid from the medical device. Can be removed and retracted and mounted on different medical devices. In laparoscopic surgery, these changes are much more complicated.

  In yet another aspect, an apparatus for illuminating a medical procedure, comprising: a base attachable to a handheld medical instrument; an illumination device attached to the base; and optionally a power source for powering the illumination device Is provided. The lighting device of this aspect may incorporate one or more of the features described in connection with other aspects. For example:

  The handheld medical device can be an electric scalpel. The illumination device can be one or more LEDs or a fiber optic light source. The base may further comprise two or more lighting devices, optionally lighting devices located diametrically opposite.

  Optionally, the base may comprise a central opening configured to attach around a portion of the handheld medical device. In some cases, the base may comprise a ring made of a relatively flexible material (eg, rubber or silicone gel, or combinations thereof) that surrounds the central opening.

  In some cases, the power source may comprise a battery mounted within the base housing. In another case, the power source may comprise an electrical cable configured to be connected to the power source.

  In some embodiments of the lighting device, another auxiliary device for use during the medical procedure may be attached to the base, optionally further including a switch for selectively activating the other auxiliary device. . Such auxiliary devices can be temperature sensors (eg, thermometers or infrared sensors), spectrophotometers, flow meters, video or photographic cameras, laser pointers, or suction devices. Some of these can also be combined.

  In yet another aspect, an elongate shaft having a receptacle at or near the distal end, a blade configured to be received within the receptacle, and a lighting device attached to the receptacle as described above. An electric scalpel is provided. In particular, the lighting device can be removably attached to the receptacle.

  Non-limiting examples of the present disclosure are described below with reference to the accompanying drawings.

FIG. 6 schematically illustrates an example of an apparatus for supporting an open surgical procedure in combination with an electric knife. 1B is a cross-sectional view of the device on the knife of FIG. FIG. 1B schematically shows details of the apparatus of the embodiment of FIG. 1A. It is a front view of the apparatus of the Example of FIG. 1A. It is a figure which shows the detail of the Example of an open surgery assistance apparatus roughly. It is a figure which shows the detail of the Example of an open surgery assistance apparatus roughly. It is a figure which shows schematically another Example of an open surgery assistance apparatus. It is a figure which shows schematically another Example of an open surgery assistance apparatus. It is a figure which shows schematically another Example of an open surgery assistance apparatus. FIG. 7 schematically illustrates another embodiment of an open surgery support device using different handheld medical devices and auxiliary medical devices. FIG. 7 schematically illustrates another embodiment of an open surgery support device using different handheld medical devices and auxiliary medical devices. FIG. 6 schematically illustrates different auxiliary medical devices that may be used with an embodiment of an open surgery support device. FIG. 6 schematically illustrates different auxiliary medical devices that may be used with an embodiment of an open surgery support device. FIG. 6 schematically illustrates different auxiliary medical devices that may be used with an embodiment of an open surgery support device. It is a figure which shows another Example of an open surgery assistance apparatus. It is a figure which shows another Example of an open surgery assistance apparatus. It is a figure which shows another Example of an open surgery assistance apparatus. It is a figure which shows another Example of the open surgery assistance apparatus substantially as mentioned above. It is a figure which shows another Example of the open surgery assistance apparatus substantially as mentioned above. It is a figure which shows another Example of the open surgery assistance apparatus substantially as mentioned above. It is a figure which shows another Example of the open surgery assistance apparatus substantially as mentioned above.

  Handheld medical devices may include various instruments or devices for several areas of application. Such an instrument may generally comprise a handle or grip portion near the proximal portion of the elongate shaft and a working instrument at the distal end of the shaft. For example, such an instrument can be an electric scalpel or an electrocautery knife that can be used in electrosurgery. Other instruments for treatment include other surgical instruments or dental or orthodontic instruments.

  Electrosurgery is usually performed in dermatology, gynecology, cardiac surgery, plastic surgery, eyes, spine, ENT, maxillofacial, orthopedic, urological, neurosurgery, and general surgical procedures, As well as in certain dental procedures. Electrosurgery is performed using an electrosurgical generator (also referred to as a power supply or waveform generator) and a hand piece (sometimes referred to as a radio frequency knife (RF knife)) that includes one or more electrodes.

  Most of the embodiments of the present disclosure are shown in combination with an electric knife. However, it is clear that the device and similar devices can be used in combination with other handheld medical devices. Other suitable medical instruments include, for example, orthodontic instruments, probes, surgical graspers or tweezers, and surgical retractors. Most of the embodiments of the present disclosure are adapted to instruments and procedures where the lighting device or another auxiliary device does not enter the body cavity completely, but rather is outside the body cavity or hardly enters the body cavity, Is suitable.

  Embodiments of the present disclosure are generally configured for open surgery where an opening is formed or formed in the patient's skin.

  1A and 1B illustrate an example of a kit or device 30 for illuminating and assisting medical procedures (eg, open surgery) in combination with handheld surgical instruments. In this example, the handheld surgical instrument is an electric scalpel with an elongate shaft 20 having a receptacle 25 having a distal open end. The elongate shaft 20 can be held by a medical professional near the proximal end of the shaft. The proximal portion of shaft 20 may have an ergonomic shape configured for gripping or manipulation. The gripping portion can extend from the proximal end of the shaft to approximately the middle portion of the shaft. The ergonomic shape can be adapted to a pencil grip.

  The electrosurgical receptacle 25 is configured to receive, for example, an electrocautery blade 24. The receptacle 25 can be made of an electrically insulating material. The receptacle 25 may be made from a rubbery material or a polymer material.

  Further, in general, a power supply system for supplying power to the scalpel and a cable connecting the proximal end of the shaft to the power supply system may be provided. The power switch allows the power to be turned on or off or otherwise adjusted for power flow.

  A kit or device 30 for assisting in open surgery in this embodiment includes a cylindrical base having a central opening 2a configured to be mounted around a portion of a handheld medical instrument, for example, around the receptacle 25. 32. Accordingly, the base 32 can be positioned by introducing the receptacle 25 into the central opening 2a. As a result, the base is positioned distally relative to the handle or grip portion of the medical device. In some examples, the cylindrical base can have a diameter of about 1 cm, 1.5 cm, or 2 cm.

  This is also shown in FIGS. 1C and 1D.

  In this embodiment, eight LEDs 3 are provided. Since the LED is distal from the medical professional's hand, the hand cannot form a shadow. The LEDs can be strategically positioned so that sufficient light is applied to the surgical field regardless of the exact orientation of the scalpel. In other embodiments, a different number of LEDs may be provided.

  Thus, the position of the electrosurgical knife on the receptacle 25 allows visualization, but at the same time does not interfere with the scalpel access to the surgical procedure. The device can be positioned sufficiently close to stay outside the patient in the case of a small body opening or body cavity.

  In this case, the base has a substantially circular truncated cone shape. However, the base may have any geometric shape as long as it is suitable for that purpose. An example of a geometric requirement is that the lighting device and medical instrument assembly be light enough to maintain the handle in a manageable manner, and that medical personnel while using the assembly. May not be sharp or bulky.

  In this embodiment, the base 32 includes a diaphragm 2 that surrounds the central opening 2a. Alternatively, an O-ring can be used. Diaphragm 2 can be made of a relatively flexible material and can be adapted to some handheld medical devices. When the base 32 is pressed against the shaft receptacle 25 or pulled away from the receptacle 25, the diaphragm 2 may be deformed to accept or release the receptacle 25 from the central opening 2a. Furthermore, the flexibility of the diaphragm can accommodate a range of distal end diameters or geometries in various handheld medical devices. This imparts versatility to the kit / device, so that the kit / device can be used with different handheld medical devices if desired.

  The kit or device 30 further comprises a cable 10 for connecting a connection for connection to a power source, ie the rear of the base 32 to the power source. Several switches in the control panel may control different systems on the device, eg, allow different systems to be turned on or off separately or simultaneously.

  At the back of the base, a power module (not shown) receives power from the connection (ie, cable 10) and supplies power to any device mounted on the base. In this case, electric power is supplied to the lighting device 3. However, in other embodiments, a laser pointer can be integrated into the base, for example, placed between lighting devices. Alternatively, one of the illumination devices shown can be replaced with a laser pointer. Thus, the power supply may receive power from the same source.

  An infrared laser pointer or a green laser pointer may be useful. The integration of the laser pointer into the assist lighting device offers several advantages over the normal use of a pen-sized laser pointer. In some embodiments, the laser pointer can be switched on and off via a switch on the power supply or cable without the need for the physician to use his hand each time the laser pointer is needed. Also, as a result, the laser can be used more accurately than if another person must be asked to switch the laser on and off.

  Furthermore, since conventional laser pointers are not sterile, precautions need to be taken to avoid contamination of the surgical field. In the embodiments of the present disclosure, the laser pointer is part of a support device that is properly sterilized and thus can be handled like any other medical device. In particular, such a feature is an advantage in medical practice because it can reduce risks such as the risk of contamination of the surgical area and the consequences of undesirable complications during patient treatment.

  In an embodiment, the back side of the base may comprise a printed circuit board that functions as a control system for the device.

  An example light source of the present disclosure can be, for example, a light emitting diode (LED), a fiber optic light source, an incandescent bulb, or the like. The light source may be shaped and / or oriented to facilitate the projection of light toward the area where the blade 24 is used. With respect to the selection of one type of light source or other light source, the selection may be made, depending on the situation, for example, to balance energy consumption, light output, color temperature, and light source lifetime (including flux maintenance). .

  LEDs provide benefits such as bright and very uniform illumination for the surgical environment. Its excellent temperature control enables high brightness light output and long life (for example, 3,000 to 7,000 hours durability of fiber optic headlights, 50,000 hours durability of LED headlights) (Creating) is possible. Another advantage is the low replacement cost of a single LED lamp. Instead, the fiber optic light source has the feature of being a thin flexible material, which can be advantageous for certain applications. These are now the most common light sources for medical applications on the market due to their suitable technical characteristics. However, other light sources may be considered for implementation in the device or kit, depending on user requirements and / or restrictions.

  If a fiber optic light source is used, an additional fiber optic cable may be provided from the base to the light source. In embodiments where only a fiber optic light source is provided (ie, there is no laser pointer for another auxiliary device), no power supply is required on the base.

  In the embodiment of FIG. 1, the kit / device 30 includes a base 32 and an appendage 39 that is removably secured to the base 32. The base 32 of this embodiment has two dovetail slots 38 located diametrically opposite each other. The appendage 39 has a suitable projection 37 having a shape complementary to the slot 38 so as to be slidably inserted into the slot 38. In this embodiment, the two appendages can be attached to the base 32 simultaneously.

  In an embodiment, the protrusion may be slightly larger than the slot (elongated groove) so that a friction fit is achieved. Friction fitting is one way to prevent the appendage from moving relative to the base 32 in an undesirable manner.

Each appendage has a through hole that serves as a receptacle for receiving an auxiliary medical device. In this case, the “primary” medical instrument is an electric knife. The auxiliary medical device can be any device that can be used with an electric scalpel during open surgery. Examples include the following.
− Video or photo camera,
-Laser pointer (for accurate indication of tissue. In embodiments, the laser may be integrated into the base. In other embodiments, the laser is an auxiliary device attached to the appendage) ,
-Sensors equipped with thermometers, flow meters, etc. The sensor can be placed at any suitable location within the base. The optimal position for installing a sensor such as a thermometer or flow meter is on the side of the base where it can more easily contact living tissue. Infrared sensors can be used to determine temperature differences between tissues that can indicate angiogenesis. The flow meter can be based on ultrasonic technology. In particular, the (ultrasonic) flow meter in the electrosurgical embodiment can help to locate the vessel. Another or alternative sensor that can be incorporated into the device for the same purpose is a spectrophotometer.
-Washing machine (in the case of electrocoagulation),
A radioactive probe (eg when cutting a tumor), or a liquid / gas aspirator (eg for aspirating smoke generation when cutting using a scalpel).

  In the latter case, such an aspirator can be combined with a REIMS spectrometer to analyze smoke immediately. (See Fig. 6A)

  In an embodiment, the auxiliary medical device or instrument supports and / or enhances the function of the medical instrument to which the device is attached.

  2A and 2B show details that may be incorporated into an example of an open surgery support device (or kit). FIG. 2A shows that the protrusion 37 configured to mate with the slot 38 may have one or more local protrusions 37a that can mate along the slot 38 into complementary local recesses 38a. ing. Engagement of the projection 37a with the local recess 38a ensures that the appendage 39 is attached to the base 32 at the correct position and stays in that position.

  In an embodiment, engagement of the protrusion 37 to the slot 38 may further provide power to provide energy to the auxiliary medical device received in the appendage.

  FIG. 2B illustrates that in an embodiment, the base can have a portion that functions as an electrical connector. In the embodiment of FIG. 2B, the bottom of the appendage may incorporate a conductive stripe 37b. When power is supplied to the base, or when power is supplied to the base, the same power can be utilized, for example, in an auxiliary device attached to the appendage.

  In yet another embodiment, a portion of the appendage can be molded as an electrical plug (or socket) and the base can be provided with a complementary socket (or plug), thus also via the base to the auxiliary medical device. Power can be supplied.

  3A-3C schematically show different views of another embodiment of a device or kit for assisting in open surgery. FIG. 3A shows an example of an open surgery support device / kit whose length is increased compared to the embodiment of FIG. Depending on which handheld medical instrument is used as the “primary” surgical instrument, the geometry of the base 32 and kit / device 30 may be adapted to the instrument. Also in this embodiment, the base 32 is tapered outward from the distal end toward the proximal end.

  FIG. 3B similarly shows that the protrusion 37 can taper outwardly from the distal end 371 toward the proximal end 372. One aspect of such a tapered protrusion (and a mating slot) can ensure the correct position of the appendage 39 relative to the base 32.

  Again, two attachments can be attached to the base 32 in this embodiment. In alternative embodiments, a base configured for a single appendage or for more than two appendages may be provided. In yet another embodiment, the appendage (s) can be integrally formed with the base. See FIGS. 7A-8B.

  4A and 4B schematically illustrate another example of a kit / device for assisting in open surgery using different handheld medical devices and auxiliary medical devices. In FIG. 4A, the kit / device 30 is attached to an ultrasonic scalpel 40.

  FIG. 4B serves to show that an additional lighting device 50, for example an incandescent bulb, can be temporarily positioned in the appendage 39 to supplement the LED 3 when intense lighting is required. Therefore, the other lighting device in this case functions as an auxiliary medical instrument.

  FIGS. 5A-5C schematically illustrate three additional auxiliary medical devices that may be used with embodiments of kits / devices to assist in open surgery. In particular, FIG. 5A shows a laser pointer 60. In particular, infrared lasers or green laser pointers are used in the operating room. In embodiments of the present disclosure, such a laser pointer or laser pen may be inserted into the receptacle of appendage 39 to point in the direction of the distal end of the main medical device.

  FIG. 5B serves to show that in some situations it may be preferable to have different wavelengths of light 51, such as infrared or UV light, instead of white light. In such a case, an appropriate LED need only be inserted into the appendage 39 to provide the necessary illumination. And FIG. 5C serves to show that in some situations it may be preferable to have a radioactive probe to measure radiation and accurately determine the location of cells and tissues affected by cancer. .

  6A-6B show a different embodiment kit or device comprising two appendages 39, 39 '. Thus, the embodiment shown in FIG. 6A is similar to FIG. 1A in that the second appendage 39 ′ is also removably secured to the base 32, substantially as described in connection with FIG. 1A. This is different from the first embodiment. Furthermore, the laser pointer 60 is attached to the appendage 39 ', substantially as described in connection with FIG. 5A. Furthermore, in this embodiment, as clearly shown in FIG. 6B, which shows a partial front view of the kit / device shown in FIG. 6A, the second appendage 39 ′ is open, ie It has a substantially C-shaped part.

  If the portion having a substantially C-shaped cross-section is sufficiently closed and / or sufficiently elastic, the auxiliary medical device can be positioned in the corresponding through-hole. The auxiliary medical device may be attached with a snap fit in embodiments.

  The kit / device of FIG. 6A also connects a tube 80 that sucks the generated smoke and leads it to the REIMS spectrometer in the same way between the first appendage 39 and the second appendage 39 ′ to the base 32. It differs from the kit / apparatus of FIG. 1A in that it can be attached to the base by an elastic strap 81 made.

  FIG. 6B shows how an elastic band or strap can function as an appendage. The elastic band can be stretched to create enough space to attach the auxiliary medical device. The auxiliary medical device in this sense is clamped between the base 32 and the elastic band.

  FIG. 6C illustrates that in another alternative, for example, a strap 82 with a Velcro® type hook-and-loop fastener can be envisaged for attaching an electrical cable to the shaft 20 of the electric knife. Thus, the electrical cable does not interfere with the movement of the surgeon or medical device.

  7A-8B show two alternative devices for assisting in open surgery. 7A and 8A are perspective views of this embodiment, and FIGS. 7B and 8B are exploded views of this embodiment. These embodiments differ from the previous embodiments in that the appendage 90 (FIG. 7) or appendage 91 (FIG. 8) is formed integrally with the substantially cylindrical base 900, 910.

  In either case, the base 900, 910 includes a central opening 901, 911 for receiving a handheld medical device, such as the electric scalpel of the embodiment of FIG. 1A. Alternatively, other handheld medical instruments, in particular surgical instruments, can be envisaged.

  Further, in these embodiments, auxiliary through-hole working channels 905, 915 can be integrally formed with the bases 900, 910. Alternatively, the working channel may comprise a C-shaped portion or a U-shaped portion so that the auxiliary medical device can be gripped, substantially as described in connection with FIG. 6A or 6B.

  The embodiment of FIGS. 7A and 7B comprises three LEDs 902 arranged around the central opening 901 and equidistant from each other at an angle of 120 °. The embodiment of FIGS. 8A and 8B comprises five LEDs 912 that are equally spaced around the central opening 911 (at an angle of 72 ° to each other).

  FIGS. 7B and 8B further show that these embodiments are made from, for example, three pieces 90a, 91a and 90b, 91b and 90c, 91c made of an elastic material. Polyamide is one suitable material in this case.

  In the embodiment of FIG. 7B, a space 904 for accommodating the LED 902 is provided between the piece 90a and the piece 90b, and a groove space 903 for accommodating any necessary wiring is formed by the piece 90a and the piece 90b. Is defined between. In the embodiment of FIG. 8B, the piece 91a is provided with a space 913 for accommodating the LED 912. Further, a groove space 914 for accommodating necessary wiring is defined between the piece 91a and the piece 91b.

  In this embodiment, the device can be manufactured and assembled relatively easily. For assembly, the three parts can be glued together. In these examples, the device incorporates a base and appendages within a single monolithic body, but in other examples, it can be a separate element that is assembled immediately before or during surgery.

  In these embodiments, an electrical cable (not shown) for connecting to a power source can further be attached, for example, to the back side of the individual piece 90a or piece 91a to provide power to the LEDs. In some cases, the laser pointer may be integrated into the base 900, 910 to point in the direction of the distal end of the main medical device that may be placed around the central openings 901, 911. The laser pointer may be placed in place of, or between, one of the LEDs, for example, substantially as described in connection with FIG.

  Different types of light may be used in any of the embodiments disclosed herein. In some embodiments, white light may be preferred.

  In some embodiments, a device or kit attached to or attachable to a medical device substantially as described above may include an illumination system configured to emit light in different wavelength ranges. In some embodiments, the wavelength of the illumination system may change during use.

  In any of the embodiments described above, the cable 10 that supplies power to the kit / device 30 may comprise a fastener for attaching the cable to the shaft 20 of the electric knife. Suitable fasteners include mounting clips, adhesives, clamps, cable ties, or Velcro® surface fasteners, to name just a few. In some embodiments, the attachment clip may be attached to the shaft by a snap connection. The mounting clip may further have an opening for receiving a connection to a cable or power source. The clip can be positioned at various locations on the shaft 20. The clip of this example can be attached to the shaft 20, for example, by sliding the clip over the shaft. Similarly, the clip can be easily removed from the shaft by sliding it off the shaft. Depending on the length and geometry of the medical device, multiple attachment clips can be used.

  In any of the embodiments described above, the device may have a timer connected to the installed lighting system. The device can be programmed to automatically turn off the light (s) and / or automatically turn off the power after a predetermined time.

  Although only some embodiments are disclosed herein, other alternatives, modifications, applications and / or equivalents are possible. Furthermore, all possible combinations of the described embodiments are also covered. Accordingly, the scope of the present disclosure should not be limited by any particular embodiment, but should be determined only by fair reading of the following claims.

2 Diaphragm 2a Center opening 3 LED
10 Cable 20 Shaft 24 Electrocautery blade 25 Receptacle 30 Kit or device 32 Base 37 Protrusion (or protrusion)
371 Distal end (of protrusion 37) 372 Proximal end of (of protrusion 37) 37a Local protrusion (s) 37b Conductive stripe 38 Slot (elongated groove)
38a Local recess (complementary along slot 38) 39 appendage 39 'second appendage 39
40 Ultrasonic scalpel 50 Additional illumination device 51 Light (of different wavelengths) 60 Laser pointer 80 Tube 81 Elastic strap 82 Strap with Velcro® type surface fastener 90 Attachment 90a (made of elastic material) Piece 90b (made of elastic material) piece 90c (made of elastic material) piece 900 base (substantially cylindrical) 901 central opening 902 LED
903 Groove space 904 Space (for accommodating LED 902) 905 Auxiliary through-hole working channel 91 Attachment 91a (made of elastic material) piece 91b (made of elastic material) piece 91c (made of elastic material) 910 (substantially Base 911 center opening 912 LED
913 Space (to accommodate LED 912) 914 Groove space 915 Auxiliary through-hole working channel

Claims (48)

A kit to support open surgery,
A base configured to be attached to a portion of a handheld medical device;
A kit configured to be removably secured to the base and an accessory having a receptacle configured to receive an auxiliary medical device.   The kit of claim 1, wherein the receptacle is a through hole. A first appendage configured to be removably secured to the base and having a first receptacle configured to receive a first auxiliary medical device;
A second appendage configured to be removably secured to the base and having a second receptacle configured to receive a second auxiliary medical device;
The kit according to claim 1 or 2, wherein the first receptacle has a different size or shape from the second receptacle.   The base includes a first fastening element, the appendage includes a second fastening element, and the first fastening element and the second fastening element are configured to mesh with each other. The kit according to any one of the above.   The kit according to claim 4, wherein the base comprises a single fastening element for coupling with either the first appendage or the second appendage.   The kit of claim 5, wherein the base comprises a first fastening element and a second fastening element for simultaneous coupling with the first appendage and the second appendage.   7. The base of any of claims 1-6, wherein the base comprises one or more lighting devices that are directed to a distal end of the handheld medical device when the base is attached to the handheld medical device. A kit according to claim 1.   The kit according to any one of the preceding claims, further comprising one or more auxiliary medical devices configured to fit into the receptacle of the appendage.   The auxiliary medical device is from the group consisting of a surgical aspirator or smoke / liquid aspirator, a laser pointer, a handheld ultrasound system, an irrigator for electrocoagulation, another illumination device, a radioactive probe, a camera, or a sensor. The kit according to claim 8, wherein the kit is selected.   The kit according to any one of the preceding claims, further comprising a handheld medical device to which the base can be attached.   11. The kit of claim 10, wherein the handheld medical instrument is selected from the group consisting of an electric scalpel, a high frequency knife, a surgical clamp, a sealant, or a cautery.   12. Kit according to any one of the preceding claims, wherein the appendage has a substantially C-shaped or U-shaped part.   13. The anti-skid strap attached to the base and defining a receptacle for the another auxiliary medical device or comprising such an anti-slip strap. The kit according to one item. An open surgery support device,
A base configured to be attached to a portion of a handheld medical device;
A lighting device attached to the base so that when the base is attached to the handheld medical device, the base is directed toward a distal end of the handheld medical device;
The base appendage having a receptacle configured to receive an auxiliary medical device;
A device comprising:   The apparatus of claim 14, wherein the receptacle is a through hole.   The apparatus of claim 15, wherein the appendage includes a tubular or annular portion that defines the through hole.   17. Apparatus according to any one of claims 14 to 16, wherein the appendage has a substantially C-shaped or U-shaped portion that defines the receptacle.   18. Apparatus according to any one of claims 14 to 17, wherein the appendage is or comprises a strap that defines the receptacle.   19. A device according to any one of claims 14 to 18, wherein the appendage is made of an elastic material so that the auxiliary medical device can be received with a friction fit.   20. An apparatus according to any one of claims 14 to 19, wherein the appendage is integrally formed with the base.   20. Apparatus according to any one of claims 14 to 19, wherein the appendage is removably secured to the base.   23. The apparatus of claim 21, wherein one of the base and the appendage comprises a slot, and the other of the appendage and the base comprises a protrusion having a shape complementary to the slot.   23. The protrusion of claim 22, wherein the protrusion and the slot extend along a longitudinal axis, the protrusion protrudes perpendicular to the longitudinal axis, and the slot comprises a recess complementary to the protrusion. apparatus.   A first appendage and a second appendage, the first appendage having a receptacle configured to receive a first auxiliary medical device, the second appendage being a first appendage 24. Apparatus according to any one of claims 14 to 23, having a receptacle configured to receive two auxiliary medical devices.   25. The apparatus of claim 24, wherein the first appendage and the second appendage are disposed at diametrically opposite positions of the base.   The appendage includes an anti-slip strap attached to the base for housing an auxiliary medical device, and optionally the anti-slip strap extends from the first appendage to the second appendage. 25. The apparatus of claim 24.   27. Apparatus according to any one of claims 14 to 26, wherein the base comprises a ring or diaphragm having a central opening to be attached around a portion of the handheld medical device.   28. The device of claim 27, wherein the ring or the diaphragm is made of a relatively flexible material surrounding the central opening, optionally rubber or silicone gel, or combinations thereof.   The base includes a hinge between the first half and the second half of the base, and a biasing element brings the first half and the second half into contact with each other. 29. The apparatus according to any one of claims 14 to 28, wherein the biasing element is optionally a spring.   30. The apparatus according to any one of claims 14 to 29, wherein the handheld medical instrument is selected from the group consisting of an electric scalpel, an ultrasonic scalpel, a high frequency knife, a surgical clamp, a sealant, or an ablation device.   The auxiliary medical instrument is from the group consisting of a surgical aspirator or smoke / liquid aspirator, a laser pointer, a handheld ultrasound system, an irrigator for electrocoagulation, another irradiation device, a radioactive probe, a camera, or a sensor. 31. Apparatus according to any one of claims 14 to 30, which is selected.   32. The apparatus according to any one of claims 14 to 31, further comprising a power source.   The apparatus of claim 32, wherein the base comprises the power source.   34. An apparatus according to claim 32 or claim 33, wherein the power source is a battery.   35. Apparatus according to claim 33 or 34, wherein the power source is an electrical cable configured to be connected to a power source.   36. The apparatus of claim 35, wherein the electrical cable comprises a plurality of fasteners for attachment to the handheld medical device.   40. The apparatus of claim 36, wherein the fastener comprises a clamp.   38. The apparatus of claim 37, wherein the fastener comprises at least a first clamp configured to be clamped around a portion of the medical device near a proximal end of the medical device.   36. The apparatus of claim 35, wherein the medical device comprises a plurality of fasteners for attaching the electrical cable to the medical device.   40. The apparatus of claim 39, wherein the fastener comprises one or more eyelets on the medical device for guiding the electrical cable.   41. The device according to any one of claims 14 to 40, wherein the base comprises two or more lighting devices.   42. The apparatus according to any one of claims 14 to 41, wherein the illumination device is an LED or a fiber optic light source. A method of replacing a first auxiliary medical device attached to a receptacle of an appendage of the device when the base of an open surgery support device is attached to a part of a handheld medical device, the method comprising:
Providing the handheld medical device in a surgical position with the appendage supporting the first auxiliary medical device;
Pulling back the handheld medical device from a surgical position;
Removing the first auxiliary medical device;
Attaching a second auxiliary medical instrument to the open surgery support device;
Positioning the handheld medical instrument in a surgical position;
The method, wherein the method is performed during open surgery.   44. The method of claim 43, wherein removing the first auxiliary medical device comprises removing the appendage from the open surgery support device.   45. The method of claim 44, wherein attaching the second auxiliary medical instrument to the open surgery support device includes attaching a second accessory to the open surgery support device. A method for changing an auxiliary medical device attached to a receptacle of an appendage of the device when the base of an open surgery support device is attached to a portion of a first handheld medical device, the method comprising:
Providing the first handheld medical instrument in a surgical position with an appendage supporting the first auxiliary medical device;
Pulling back the first handheld medical device from a surgical position;
Removing the open surgery support device from the first handheld medical instrument;
Providing a second handheld medical device;
Attaching the open surgery support device to the second handheld medical instrument;
Positioning the second handheld medical instrument in a surgical position;
The method, wherein the method is performed during open surgery.   47. The method of claim 46, wherein attaching the open surgery support device to the second handheld medical device comprises attaching the device to the second handheld medical device with the same auxiliary medical device.   47. The method of claim 46, wherein attaching the open surgery support device to the second handheld medical device comprises attaching the device to the second handheld medical device with a different auxiliary medical device.

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